ABSTRACT
Abdominoscrotal hydrocele (ASH) represents a rare condition characterized by abdominoscrotal cystic enlargement that exhibits hourglass-shaped, fluid-filled accumulation communicating with scrotal and abdominal components on contrast-enhanced computed tomography. We present the case of a 44-year-old patient who presented with swelling in the right scrotal and abdominal regions. Upon examination, a positive cross-fluctuation was observed between the right scrotal swelling and the abdominal swelling, raising suspicions of ASH, which was subsequently confirmed radiologically. The patient underwent a right-sided sac excision and sac ligation at the deep ring performed through a right inguinal approach and subsequently experienced a smooth and uncomplicated recovery during the postoperative period. Surgical repair is the most common management approach rather than conservative management, and the use of an inguinal method over other surgical methods facilitates a lower risk of inadvertent injury to adjacent anatomical structures.
ABSTRACT
BACKGROUND: Fibro lipoma of the spermatic cord is a very rare tumor with few cases reported in literature. Atypical presentation and site of swelling mystifies the diagnosis and creates bewildering situation intraoperatively. Case Summary. A 30-year-old farmer presented with an elastic firm nonreducible, nontender swelling at inguinoscrotal region with positive cough impulse and history of laparoscopic inguinal hernia repair 3 years ago. Ultrasonography of the swelling revealed a heteroechoic lesion of size 7 × 6 centimeter with probable features of lipoma or desmoid. Fine needle aspiration drawn in consideration of the diagnostic dilemma reported a benign lipomatous swelling which on final histopathology turned out to be a fibro lipoma of size 7 × 6 × 5 cm. CONCLUSION: Considering the age and presentation of the patient, it was astonishing. It provided an insight to the occurrence of fibro lipoma even in younger age group which in fact is the first case of its kind as per best of our knowledge. Malignancy should be ruled out in such cases, and complete excision is the treatment of choice.
